Transfusión sanguínea autóloga: Revisión de la literatura

Miguel Giovanni Paredes Aspilcueta; Victoria Elvira Butrón Verástegui

doi:10.33421/inmp.2024442

Autores/as

Miguel Giovanni Paredes Aspilcueta Universidad Nacional Mayor de San Marcos, Lima, Perú. Instituto Nacional Materno Perinatal, Lima, Perú. Médico patólogo clínico.
Victoria Elvira Butrón Verástegui Universidad Ricardo Palma, Lima, Perú. Estudiante de la Facultad de Medicina Humana.

DOI:

https://doi.org/10.33421/inmp.2024442

Palabras clave:

Transfusión de Sangre Autóloga, Conservación de Sangre, Hemodilución, Recuperación de Sangre, Reacción Transfusional

Resumen

Introducción: La transfusión sanguínea autóloga, también denominada autotransfusión, permite que un paciente reciba su propia sangre previamente extraída y conservada, reduciendo riesgos asociados a la transfusión homóloga. Objetivo: Analizar y describir las modalidades de transfusión autóloga, sus beneficios, indicaciones, limitaciones y riesgos en distintos escenarios clínicos. Métodos: Se realizó una revisión narrativa de estudios publicados entre 2015 y 2025 en bases de datos biomédicas como PubMed, Cochrane y la Organización Panamericana de la Salud (OPS). Se incluyeron 43 referencias, abarcando revisiones sistemáticas, ensayos clínicos y estudios observacionales. Se evaluó la calidad metodológica de los estudios y se sintetizó la información en función de cada modalidad de transfusión autóloga: depósito prequirúrgico, hemodilución normovolémica aguda y recuperación intraoperatoria de sangre. Resultados: Se identificó que la transfusión autóloga reduce la necesidad de sangre homóloga, minimiza el riesgo de reacciones inmunológicas y mejora la seguridad transfusional. El depósito prequirúrgico es útil en cirugías electivas con alto riesgo de sangrado, la hemodilución normovolémica en procedimientos con pérdidas sanguíneas moderadas y la recuperación intraoperatoria en hemorragias masivas. Sin embargo, se señalaron costos elevados, necesidad de infraestructura especializada y restricciones en pacientes con anemia severa como limitaciones. Conclusión. La transfusión autóloga es una estrategia clave en la medicina transfusional. Su implementación depende de la infraestructura y planificación hospitalaria. La integración de estrategias de Manejo del Paciente Sanguíneo (PBM) y protocolos estandarizados optimizará su aplicación clínica.

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